A rug to cover the medallion would be a good solution to your problem.

Hi there, I have a room like this, with a dominating fireplace in a relatively small space, and I have found that balance and height are key. I suggest removing all the accessories from near the fireplace; the big picture could be hung instead on the facing wall, preferably a little higher than usual. Place a mirror with minimal framing above the fireplace. Then replace just the tall slim vases and the fire tools. Next lift all the other items higher; put painted blocks or low drawers under the shelves and lift them right up toward the picture rail. Raise the television preferably using a base that is a white colour similar to the fireplace surround and other trims. Remove all items placed near to the ground - the pictures and knick knacks - adding a high shelf on a wall to display them would be great. Then maybe recover/replace some of the scatter cushions with lighter fabrics. I think your room would then be lovely, the very attractive fireplace balanced by the other proportions. Good luck, louise